Routine inspection·August 28, 2024

On 8/28/2024, Licensing Program Analysts (LPAs) Murial Han and Yi Sam Jian conduced an annual inspection. Upon entrance, LPAs were greeted by caregiver, Miao Fen Yu and LPAs explained the purpose of the visit. The administrator, Michael Lee arrived shortly thereafter and assisted with the inspection. LPAs toured the facility. This facility is 3 floors and a basement level. There are no obstructions blocking indoor and outdoor passageways. No pools or bodies of water observed. Backyard is fenced, secured, and in good condition. Facility temperature is comfortable measured at 72F per thermostats observed and lighting is sufficient for comfort. Resident rooms are on the 1st, 2nd and 3rd floor with double occupancy. Extinguishers last inspected on 6/18/2024 and emergency drills were reviewed. Spare linens and blankets are observed. Cleaning solutions are stored and locked in basement level. LPAs reviewed 2 day perishable and 7 day nonperishable food supplies as in place. Additional food supplies are located in the basement level which contains 2 large freezers and additional canned and fresh produce. Central stored medication, toxins and sharps objects were locked and inaccessible to residents. A review of (6) resident files was conducted and noted on the LIC 858. A review of (4) staff files was conducted and noted on the LIC 859. During the tour with the administrator, LPAs observed a resident's over bed table has silver tape all around the edges, bathroom doors has chipped paint on the bottom, bathroom door frames have chipped paint and broken wood on the bottom, two of the kitchen cabinet doors are broken, a couch on the 2nd floor has silver tape around the right armrest, the toilet paper on the 3rd floor bathroom is held up by a plastic bag, broken floor in front of a resident's room on the 2nd floor and multiple chipped doors and door frame edges through-out the facility. LPAs requested for the following documents to be submitted to CCL by 8/30/2024 to update the administrator: LIC 500, LIC 503, LIC 308, a written letter from the licensee appointing the administrator and a copy of the administrator certification or proof that it is in the process of being renewed. Based on observation, deficiency is cited under California Code of Regulations, Title, 22 cited on the LIC 809D. Failure to correct the deficiencies may result in civil penalties. This report is reviewed and discussed with the administrator. A copy of this report and the appeal rights were provided.